Individual provider Active NPI

Nowell Johnson, FNP-C

  • Family Nurse Practitioner
  • Thief River Falls, MN
National Provider Identifier
1902678428
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10930 Issued in MN
Practice address
1845 US Highway 59 SE Ste 800
Thief River Falls, MN 56701-4318
Phone
(218) 681-7280
Fax
(701) 780-2489
NPI assigned
Oct 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 10930 MN Primary

Addresses

Primary practice location

1845 US Highway 59 SE Ste 800
Thief River Falls, MN 56701-4318

Mailing address

1845 US Highway 59 SE Ste 800
Thief River Falls, MN 56701-4318
Phone (218) 469-3181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240119003823 MN Practitioner - Nurse Practitioner 7618329103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Altru Health SystemGroup PAC ID 1355251604, 675 clinicians

Practice addresses (Care Compare)

1845 Hwy 59 S
Suite 800
Thief River Falls, MN 56701-4318
Phone (218) 681-7280

400 S Minnesota St
Crookston, MN 56716-1808
Phone (218) 281-9100

Hospital & facility affiliations

  • Hia Hospice Hospice, Fargo, ND, CCN 351500
  • Altru Hospital Hospital, Grand Forks, ND, CCN 350019

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Altru Health System Current Accepting new patients
Altru Health System CurrentSince Dec 31, 2023 Accepting new patients
Altru Health System CurrentSince Dec 31, 2023 Accepting new patients
Altru Health System Past Accepting new patients

Locations

400 S Minnesota St
Crookston, MN 56716
Phone (218) 281-9100

1845 US Highway 59 SE
Ste 800
Thief River Falls, MN 56701
Phone (218) 681-7280

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1698364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1902678428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1845 US HIGHWAY 59 SE STE 800",
            "city": "THIEF RIVER FALLS",
            "state": "MN",
            "postal_code": "567014318",
            "telephone_number": "218-469-3181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 US HIGHWAY 59 SE STE 800",
            "city": "THIEF RIVER FALLS",
            "state": "MN",
            "postal_code": "567014318",
            "telephone_number": "218-681-7280",
            "fax_number": "701-780-2489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NOWELL",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-27",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "10930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thief River Falls, MN

Sources for this page

Verify at the official NPI Registry.